Since it is usually diagnosed at a later and more advanced stage, pancreatic cancer can be a difficult disease to treat. Thus, therapy needs to be rapid and aggressive — requiring the expertise of experienced specialists — to ensure optimal results and best chance at a cure.

City of Hope has one of the most renowned pancreatic cancer programs in the United States, with a multidisciplinary team of medical experts across different fields including surgery, radiation oncology, medical oncology and supportive care medicine. Together, they work collaboratively to plan and implement a treatment regimen that is individually tailored to the patient to enhance outcomes and quality of life.

Surgery

Surgery
can be curative for early stage pancreatic cancer patients and can also improve survival outcomes and reduce discomfort for advanced pancreatic cancer patients.

To treat pancreatic cancer, the surgeon may perform:

Whipple procedure: removing the head of the pancreas along with nearby structures such as the bile duct, gallbladder and part of the stomach and small intestine.

Total pancreatectomy: removing the entire pancreas along with bile duct, gallbladder, nearby lymph nodes and parts of the stomach and small intestine.

Distal pancreatectomy: removing the tail portion of the pancreas, sometimes with the spleen.

Ablative treatments: instead of removing the tumor, this therapy uses extreme heat or cold to destroy the tumor while it’s still in the body.

Embolization: this type of therapy aims to kill the tumor by cutting of the blood supply that feeds it.

Surgery may also be performed to alleviate symptoms associated with pancreatic cancer, such as a gastric or biliary bypass if the tumor is blocking the flow of food or bile, respectively.

The expertise of City of Hope’s surgeons also means that they can treat pancreatic cancers that are considered inoperable elsewhere. This is done through advanced procedures that can navigate around sensitive areas (such as major blood vessels) and working with radiation and medical oncologists, who may be able to shrink the tumor to down to an operable size and shape with radiation and drug therapies.

Radiation Therapy

Radiation
can be used alone or in conjunction with other therapies to treat pancreatic cancer by killing cancer cells or preventing the tumor growing larger. It can be applied externally using one or more radioactive beams focused on the tumor or internally by placing small radioactive pellets into or next to the tumor (brachytherapy).

Radiation therapy can also improve quality of life by relieving pain and stopping bleeds.

In addition to standard radiation regimens, City of Hope also offers
Helical TomoTherapy
, an advance technology combining radiation delivery with advanced imaging that results in more focused beams of radiation focused on the tumor while minimizing exposure to adjacent tissues and organs, including the heart, lungs and spine.

Drug Therapy

City of Hope uses a wide range of chemotherapy and targeted therapy drugs to treat localized and metastatic pancreatic cancer. In addition to standard drug regimens, patients have access to newly developed drugs (or drug combinations) through our clinical trials program.

Cancer fighting drugs can also enhance the effectiveness of surgery or radiation therapy, by shrinking the tumor before the procedure and making it easier to remove (neoadjuvant therapy), or given after the procedure to minimize the chance of recurrence (adjuvant therapy.)

Chemotherapy may also be given alongside radiation therapy to enhance the cancer-fighting effectiveness of both (chemoradiation.)

As part of the treatment team, a
medical oncologist
will evaluate the patient’s cancer, health and other factors, so that the chemotherapy, if appropriate, can be tailored to the patient throughout the continuum of care.